Severe asthma (SA) is treated by conventional therapy and biologics. The percentage of patients with SA who achieve clinical remission (CR) in a real clinical practice needs further investigation.

The aim of this study was to assess the rate of CR in SA patients treated with conventional therapy only or conventional therapy + biologics during 5 years in a single secondary care center.

Methods. We examined 138 adult outpatients (32% male, aged 18 – 81 years) with SA every 3 – 6 months for 5 years. Eighty-six patients were treated by conventional therapy only and 52 patients additionally received biologics [omalizumab (n = 10), mepolizumab/benralizumab (n = 22), dupilumab (n = 20). Lung function was assessed by spirometry with bronchodilator reversibility test using Spirograph 2120 (Vitalograph, Great Britain). Blood eosinophils (EOS) were measured by impedance methods using an automatic haemoanalyser. Atopic status was determined by positive skin prick-test (> 3 mm) and/or serum specific IgE to common inhalant allergens. Exhaled nitric oxide (FeNO) was measured by a chemiluminescence analyzer (Logan-4100; Logan Research, Rochester, UK). Asthma control and quality of life were assessed by using the Russian versions of ACQ-5 and St. George’s Respiratory Questionnaire (SGRQ). Clinical remission was defined as absence of exacerbations and systemic corticosteroid (SCS) use during previous year, controlled/partly controlled symptoms (mean ACQ-5 < 1,5), and optimal/best lung function (FEV1 ≥ 80% predicted/FEV1 increase ≥ 100 ml). These criteria were assessed every year. Statistical analyses were performed using parametric and non-parametric methods with Statistica 0.0 (StatSoft, Inc., USA).

Results. During this 5-year study, CR was reached in about 20% of SA patients additionally treated with biologics and in about 7% of patients who received conventional therapy only. CR was more frequent in patients with preserved baseline lung function, absence of maintenance SCS use, rare exacerbations, better asthma control and quality of life. The number of SA patients who fulfilled CR criteria was higher after 3 years of biologics treatment.

 Conclusion. During 5 years of follow-up, the rate of CR in patients with SA treated with biologics was approximately three times higher compared to those treated with conventional therapy only. It confirms that biologics treatment needs to be started earlier and continued if effective.

Progressive pulmonary fibrosis (PLF) is a group of chronic interstitial lung diseases (ILD) that share common clinical, functional and radiological characteristics and have unfavorable prognosis.

The aim was to study the structure and course of PLF in patients with chronic ILD.

Methods. A retrospective analysis of 463 medical records of patients with chronic ILD aged 18 to 80 years was carried out for the period from January 2020 to December 2023. PLF was diagnosed based on the criteria of the American Thoracic Society (2022). Statistical data processing was carried out using the Statistica 10.0 program.

Results. Signs of PLF were detected in patients with idiopathic pulmonary fibrosis (ILF) in 91.1% of cases, in patients with ILD associated with systemic scleroderma (SSD) – in 71.4% of cases; in patients with hypersensitive pneumonitis (HP), nonspecific interstitial pneumonia (NSIP) and undifferentiated ILD – in 47.5%, 44.4%, and 31.1% of cases, respectively. The progression of pulmonary fibrosis in ILD associated with rheumatoid arthritis (RA) was 16.6%, in sarcoidosis – 2.5%. PLF was statistically significantly more often recorded in men with chronic HP (60% in men vs 40.5% in women; χ² = 3.4; p = 0.02); and significantly more often in women with unclassified ILD (39% in women vs 24.5% in men; χ² = 4.2; p = 0.033). Regardless of gender, patients with PLF were older than patients with ILD without signs of PLF (63.1 ± 8.7 years vs 53.8 ± 17.2 years; p = 0.007)

 Conclusion. Signs of PLF were detected in 32.6% of patients with ILD. The highest incidence of PLF was recorded in the group with ILF and HP, the lowest in lung sarcoidosis. Regardless of gender, patients with ILD and PLF were older than patients without signs of PLF.

The development of pulmonary fibrosis (PF) and its progression are the most important determinants of the prognosis of interstitial lung diseases (ILD). Late diagnosis is a global problem that necessitates the search for simple and reliable prognostic biomarkers.

The aim of the study was to investigate the potential value of the level of peripheral blood monocytes as a biomarker of ILD severity.

 Methods. A cross-sectional study was conducted involving patients with ILD (n = 50). Based on the stratification by the GAP scale (G – gender, A – Age, P – Physiology (lung function parameters)), the patients were divided into 2 groups: group 1 (GAP I) scored from 0 to 3 points on the GAP scale, group 2 (GAP II and III) scored ≥ 4 points. Intergroup comparisons were performed. Subanalyses were conducted to assess the effect of monocytosis on the presence or absence of fibrotic changes according to chest computed tomography (CT) data, as well as to clarify the discriminatory ability of monocytosis as a biomarker of ILD severity and the potential of the cut-off point of the monocyte level of 600 cells/μl.

Results. Patients with more severe fibrotic changes according to chest CT data showed a higher serum level of monocytes, and a significant correlation was noted between the degree of monocytosis and the severity of interstitial changes in the lungs according to the Warrick scale. However, a greater degree of decrease in forced vital capacity and forced expiratory volume in 1 second was noted in patients whose monocyte level was equal to or exceeded 600 cells/μl.

Conclusion. The study revealed a higher level of monocytes in the peripheral blood of patients with ILD of greater severity according to the GAP scale, and demonstrated the discriminatory potential of the threshold value of the monocyte level equal to and exceeding 600 cells/μl in identifying patients with a higher degree of impairment of the pulmonary ventilation capacity and the prevalence of interstitial changes in the lungs. The ongoing study of non-invasive biomarkers of ILD severity and predictors of LF progression seems to be one of the most pressing issues in modern respiratory medicine.

Fractional exhaled nitric oxide concentration (FeNO) is a biomarker of eosinophilic airway inflammation and a reliable predictor of corticosteroid therapy.

The aim was to assess the concentration of FeNO in patients with asthma of different severity, depending on age. Methods. Our study involved 489 patients with asthma aged 4 to 68 years. 305 (62%) patients were diagnosed with asthma based on clinical symptoms and laboratory and instrumental diagnostics. The control group included 184 (38%) patients without asthma. All patients were divided into age groups: under 7 years, 8 – 10, 11 – 14, 15 – 18, 19 – 30, 31 – 55 years, and 56 years and older. FeNO level was measured according to the American Thoracic Society/European Respiratory Society recommendations using a portable hand-held nitric oxide monitor NOBreath (Bedfont Scientific Ltd, UK). Statistical processing of quantitative data was performed using Microsoft Office Excel 2016 and Statistiсa 10.0.

Results. FeNO concentration in patients with asthma was age-related. It did not exceed 35 ppb regardless of the presence of asthma and its severity in children under 7 years of age. FeNO concentration was 2 times higher in patients with asthma over 8 years of age than in the younger patients. FeNO values were comparable in the patients aged 19 – 68 years, while the range of FeNO values (M; 95% CI) in elderly people (over 55 years) was significantly wider, which may be associated with many comorbid factors and concomitant diseases. Elevated FeNO concentrations were detected 1.6 – 2 times less frequently among adult patients with mild asthma than in patients with moderate and severe asthma. The opposite trends were observed in children.

Conclusion. Elevated FeNO levels in young children can serve as a sensitive biomarker reflecting changes in the respiratory mucosa.

Bitter taste receptors (TAS2R) are expressed not only in the oral cavity, but also in many tissues of the body, including various cells of the respiratory tract. Activation of TAS2R is accompanied by inhibition of the inflammatory process, improvement of mucociliary clearance and relaxation of bronchial smooth muscles – effects that are potentially beneficial for the treatment of asthma. Despite this, studies of the role of TAS2R gene polymorphisms in the pathogenesis of asthma remain scarce.

The aim was to study the association of single nucleotide polymorphisms (SNPs) rs713598, rs1726866 and rs10246939 of the TAS2R38 gene with asthma, lung function and immunological markers in relation to the smoking status of the subjects.

Methods. The case–control study enrolled 420 subjects, including 225 patients with asthma and 195 healthy individuals (control group). Lung function parameters were determined using spirometry. SNPs were genotyped using asymmetric PCR with oligonucleotide probe melting analysis or PCR with high-resolution melting analysis of amplification products. Cytokine concentrations were measured in serum using immunofluorescence assay on microbeads. Total IgE levels were assayed using enzyme immunoassay.

 Results. We found that the AVI/AVI diplotype was more common in asthma patients who smoked compared to non-smokers after adjustment for gender and age (OR 2.0 95% CI (1.06 – 3.63); p = 0.03), but it was not associated with smoking in the control group. In smokers, this diplotype contributed to the development of asthma regardless of gender, age, and pack-year index (OR 2.1 95% CI (1.07 – 4.22); p = 0.03). In addition, the AVI/AVI diplotype was associated with severe bronchial obstruction (FEV1 < 60 %) in patients with asthma after adjustment for gender, age, and pack-year index (OR 2.3 95 % CI (1.14 – 4.78); p = 0.02). Finally, carriers of the AVI/AVI diplotype were characterized by higher serum IL-6 levels (10.5 (6.2 – 20.2) pg/ml) compared to AVI/ PAV heterozygotes (6.7 (2.5 – 11.4) pg/ml; p = 0.005) and PAV/PAV homozygotes (6.4 (4.3 – 9.4) pg/ml; p = 0.01).

Conclusion. The AVI/AVI diplotype encoding a nonfunctional variant of TAS2R38 receptor is associated with a predisposition to smoking in patients with asthma, a predisposition to the development of asthma in smokers, as well as with severe bronchial obstruction and increased IL-6 production in the studied patients.

The most formidable complication and the most common reason for hospitalization of patients with chronic obstructive pulmonary disease (COPD) is respiratory failure (RF), in the treatment of which respiratory support is actively used. However, respiratory support is ineffective in 30% of patients with severe exacerbation of COPD combined with hypoxemia and hypercapnia, which necessitates the search for new methods to correct RF.

The aim of the study was to determine the efficacy and safety of thermal heliox (t-He/O₂) in the treatment of exacerbation of COPD complicated by hypoxemic and hypercapnic RF and secondary pulmonary hypertension (PH) (group III according to the classification of the World Health Organization).

 Methods. The comparative controlled parallel prospective study included patients (n = 80: 49 men, 31 women) with exacerbation of COPD of categories C and D according to the criteria of the Global Initiative for Chronic Obstructive Lung Disease (GOLD, 2021 – 2023), complicated by hypoxemic, hypercapnic respiratory failure and PH. The patients (n = 80) were similar in demographic, clinical and functional parameters and received noninvasive ventilation (NIV) with biphasic positive airway pressure (BiPAP S/T) and oxygen (O₂) to maintain hemoglobin oxygen saturation (SpO₂) at 95–97% in addition to standard drug therapy. The patients were divided into 2 groups: group 1 (n = 40: 25 men, 15 women) received t-He/O2 inhalations twice a day for 30 min (a total of 60 min per day); group 2 (n = 40: 24 men, 16 women) did not receive t-He/O₂ inhalations. The dynamics of the clinical condition of patients, gas exchange in the lungs, acid-base balance, left-to-right shunt fraction, oxygen delivery, integral hemodynamic indices, external respiratory function (ERF), and exercise tolerance (ET) were assessed.

Results. When using t-He/O₂ in patients with COPD with hypercapnic, hypoxemic DN and PH against the background of standard therapy, a positive effect was demonstrated not only on the clinical condition of patients, but also on central hemodynamics, as well as a significant improvement in ERF, ET, arterial blood gas composition, acid-base balance and intrapulmonary shunt fraction, partial pressure of oxygen and carbon dioxide in arterial blood, hemoglobin oxygen saturation, as well as the concentration of bicarbonate ions and lactate in arterial blood compared with such indices in patients in the control group.

Conclusion. It has been established that t-He/O₂ inhalations in parallel with NIVL are safe and effective compared to oxygen therapy, while improving cardiac function and the clinical condition of patients, reducing the severity of dyspnea and signs of hypoxemia and hypercapnia, increasing the ET due to increased oxygen delivery to tissues, normalizing gas exchange in the lungs, reducing the shunt fraction, and restoring the level of bicarbonates and lactate in the blood.

Periods of increased incidence of respiratory viral infections are associated with increased risk of misdiagnosing other diseases with respiratory symptoms, including tuberculosis.

The purpose of the study is to analyze the problem of differential diagnosis of pulmonary tuberculosis during the COVID-19 pandemic.

 Methods. The study was conducted at a city hospital that accepts patients with suspected new coronavirus infection around the clock. Two groups were recruited over 12 months using the continuous sampling method. The first group included 21 patients who were diagnosed with newly developed pulmonary tuberculosis that was initially diagnosed as coronavirus, the second group included 37 patients treated with the diagnosis of a new coronavirus infection. Statistical data processing was performed in MedCalc 19.2.6. Statistical Software.

Results. The percentage of men was higher in the group with tuberculosis. No statistically significant differences were found in the medical history. Statistically significant differences between the studied groups were observed in total bilirubin, total protein, C-reactive protein, fibrinogen, ESR, hemoglobin, erythrocytes, leukocytes, platelets, age, the presence of sputum, loss of smell. The logistic regression method was used. Stepwise elimination led to a model that presents the most significant six indicators which can be useful in the differential diagnosis of tuberculosis and coronavirus in patients with a negative PCR test for coronavirus: hemoglobin, fibrinogen, leukocytes, ESR, CRP, and the presence of sputum.

Conclusion. Regardless of the current epidemiological situation for seasonal respiratory infections, tuberculosis does not lose its significance as an infectious disease that requires timely and competent differential diagnosis

Despite the steady decline in the main epidemiologically significant indicators of tuberculosis in Russia, the problem remains of choosing an affordable and informative diagnostic test for the timely detection of latent tuberculosis infection (LTI).

The aim of this study was to evaluate the compatibility of various methods of immunological diagnosis in adult patients with LTI with a high (LTI-HR) and low (LTI-LR) risk of developing tuberculosis, as well as in patients with established tuberculosis of the respiratory system.

Methods. A cross-sectional open single-center study was conducted, which included 100 adult patients. The first group included 50 conditionally healthy individuals with LTI-LR. The second group of patients consisted of 25 people with LTI-HR. The third group of patients included 25 patients with tuberculosis of the respiratory system (TRS). All participants were examined once using six immunological diagnostic tests: Mantoux test with 2 units PPD-L, Diaskintest, T-SPOT®.TB, QuantiFERON®-TB Gold Plus, Standard E TB-Feron IGRA and IGRA-TB. The end point of the study was the overall percentage consistency of the results, that is, the ability of the tests to correctly predict the condition assumed by the combination of clinical signs.

Results. The proportion of “correct results” (positive in the TRS and LTI-HR group and negative in the LTI-LR group) was 83% for the IGRA-TB test, 80% for the Diaskintest, 80% for the QuantiFERON®-TB Gold Plus test, 78% for the Standard E TB-Feron IGRA test, 67% for the T-SPOT®.TB test (p > 0.05). Only the Mantoux test with 2 units PPD-L showed significantly lower “accuracy” in our study (53%; p < 0.05).

Conclusion. The new Russian test IGRA-TB is not inferior to its foreign counterparts and can be recommended in practical healthcare as a diagnosis of latent tuberculosis infection in adults. It seems fundamentally important to continue studying the informative value of tests in adult patients in real clinical practice without applying strict selection criteria. The immunological features of the patients, which determine the different sensitivity of the tests, need to be further studied.

Numerous studies in recent years have demonstrated that oxidative stress (OS) is one of the most important pathophysiologic mechanisms of chronic inflammation in the bronchial wall of asthma patients. OS contributes to chronic inflammation and airway remodeling.

The aim of this review was to investigate the role of OS in patients with severe asthma (SA) and therapeutic options for OS improvement based on analysis of literature data from PubMed and Google Scholar databases for the period 2020 – 2025.

Methods. 83 PubMed and Google Scholar publications were selected for the review by searching the following keywords: oxidative stress in SA, OS treatment in SA, and antioxidant therapy in SA.

 Conclusion. OS plays a crucial role in the pathogenesis of SA, contributing to the formation and maintenance of chronic inflammation in the bronchial wall, bronchial hyperreactivity and remodeling, persistence of symptoms, and decreased ventilatory function of the lungs. Search and development of innovative treatment methods aimed at reducing the severity of OS in the bronchial wall, in particular inhalation therapy with a thermal helium-oxygen mixture, may be of particular interest in the complex therapy of SA in order to establish the most comprehensive control of the disease.

The cyst of Hattori is a rare pathology occurring only in women. Only about 45 – 50 cases have been described in literature up until now. All cases were reported in foreign sources, there were no reports in Russian-speaking media. The etiology of disease is still unknown, however the disorder of Mullerian duct development (embryonal anlage of female reproductive system) was suggested as the cause. X-ray imaging of the cyst of Hattori is very nonspecific. The cyst should be differentiated with pleural tumors, lung tumors, bronchogenic and celomic mediastinal cysts. The diagnosis is verified by histology augmented with immunohistochemistry assays of the surgical sample.

The aim of the review was to inform the pulmonologists, general practitioners, infectious disease specialists, thoracic surgeons, oncologists and gynecologists about the cyst of posterior mediastinum that develops from the remnants of Mullerian duct, about its diagnosis, clinical course, and treatment. Also we present one clinical case of patient with Hattori’s cyst.

Conclusion. The cyst of Hattori is very rare in clinical practice. However, physicians should know about it and include it into differential diagnosis when rounded shadows are identified in mediastimun by chest X-ray. The development of the disease is related to the embryonal disorders of Mullerian duct formation. Not only the light microscopy, but also immunohistochemical assays are necessary for the morphological confirmation of the diagnosis. The specific feature of cyst of Hattori is positive staining for the estrogen and progesterone receptors of the cells lining the cyst. Surgical excision is recommended for diagnosis, to improve the symptoms, and to exclude potential origin of the malignant transformation in the embryonal tissues of Mullerian duct. A forecast for the cyst of Hattori is favorable.

The use of CFTR modulators in patients with cystic fibrosis (CF) during pregnancy and the impact of this therapy on the health of the mother and fetus are actively discussed in the international CF medical literature. Clinical data are accumulating to build consensus recommendations on this issue.

The aim of the article is to present the first case of pregnancy and childbirth during CF treatment with a CFTR modulator in the Republic of Kazakhstan. This is also the first published experience of using the generic triple combination targeted medication elexacaftor/tezacaftor/ivacaftor+ ivacaftor (Trilexa®, Tuteur S.A.C.I.F.I.A., Argentina) in a patient with CF during pregnancy. The clinical course of the disease before and after the initiation of pathogenetic therapy are highlighted. Significant clinical improvement was observed, including a reduction in the frequency of infectious exacerbations, improved lung function, and weight gain. Pregnancy occurred during targeted therapy and was successfully carried to term.

Conclusion. The presented case illustrates the high clinical efficacy and safety of the three-component targeted CF therapy in general and the used generic medication in particular. Considering the obtained data, it is advisable to expand the number of patients with CF receiving targeted therapy in Kazakhstan, both children and adults.

The term “amyloidosis” unites a group of rare diseases characterized by extracellular deposition of an insoluble fibrillar protein amyloid. Light chain amyloidosis (AL amyloidosis) is one of the most common and severe forms of this pathology that affects the heart (in the vast majority of patients), kidneys, gastrointestinal tract, nervous system, and skin. Without treatment, it takes from 6 to 12 months from the appearance of the first symptoms of heart damage to death. The diagnosis of AL amyloidosis is challenging due to the variety and non-specific nature of clinical manifestations and the need for morphological verification of the diagnosis. The possibilities of treating amyloidosis have significantly expanded recently and have made it possible to radically change the prognosis of the disease. However, the therapy can only take full effect with early diagnosis and the absence of irreversible organ damage.

The aim of the work is to demonstrate the complexity of diagnosis of this condition and the available treatments for the timely identified AL amyloidosis.

Conclusion. The presented clinical case demonstrates the potential of a multidisciplinary approach for early diagnosis and treatment of AL amyloidosis.

Chronic obstructive pulmonary disease (COPD) is a progressive disease involving persistent airflow limitation and a chronic inflammatory response of the airways. Recent clinical guidelines emphasize the importance of bronchodilators as the primary pharmacological treatment for COPD.

The aim this review was to examine the evolution of therapeutic approaches to COPD treatment, focusing particularly on the fixed-dose combination of indacaterol and glycopyrronium (FCIG).

Methods. Clinical trials evaluating the efficacy and safety of FCIG compared to monotherapy and other combination drugs were analyzed. The review discusses the synergistic mechanisms of long-acting beta-2 agonists (LABA) and long-acting anticholinergic drugs (LAMA), as well as the potential benefits of their simultaneous use. The review pays special attention to the effect of the fixeddose combination on lung functional parameters, exacerbation frequency, and patients’ quality of life, as well as its application in different clinical situations.

Results. The results of the analysis indicate significant clinical advantages of a fixed combination of FCIG in the treatment of patients with COPD of moderate to severe severity of bronchial obstruction. Results from an international, multicenter, randomized, open-label, comparative clinical trial evaluating the efficacy and safety of the generic combination of glycopyrronium bromide and indacaterol – drug Respihale® (PSK Pharma LLC, Russia) versus the branded drug Ultibro® Breezhaler® (Novartis Pharma AG, Switzerland) in patients with moderate COPD are also presented.

Conclusion. The fixed-dose indacaterol-glycopyrronium combination is a highly effective therapeutic option for patients with COPD, providing significant advantages over LAMA or LABA monotherapy, and in some clinical situations, compared with the LABA/ICS combination. To date, the first domestic dual bronchodilator containing glycopyrronium bromide and indacaterol has appeared on the market – the drug Respihale® (PSK Pharma LLC, Russia). The conducted clinical equivalence study confirmed non-inferiority and comparable safety of the reproduced drug in patients with moderate COPD.

In the context of rapid technological advancement and evolving standards of medical care, the professional development of physicians and nurses has become a key factor in ensuring the quality of healthcare services.

The aim of the article was to demonstrate the experience and analysis of statistical data on participation in continuing professional development (CPD) programs by the staff of the Federal State Budgetary Institution “Pulmonology Scientific Research Institute” under the Federal Medical and Biological Agency of the Russian Federation.

Conclusion. The study identifies key barriers and enabling factors affecting the learning and offers practical recommendations for optimizing professional development systems at the institutional level.

Currently, pulmonary vascular endothelial dysfunction is reported to be one of the pathogenic mechanisms of pulmonary hypertension, including high-altitude pulmonary hypertension. However, direct assessment of pulmonary vascular endothelium function is possible only by using complicated invasive methods, which are not always available even in specialized centers. Systemic vascular endothelial function assessment with a noninvasive photoplethysmographic method in combination with saliva nitric oxide level measurement is a fast and easily reproducible test that may indirectly indicate the development of pulmonary vascular endothelial dysfunction and, as a consequence, pulmonary hypertension.

The aim of the study was to evaluate arterial stiffness and endothelial function in healthy volunteers at low (760 m) and high altitudes (3,600 m above sea level).

Methods. Healthy volunteers (n = 140: 47 men, 93 women; average age – 22.53 ± 2.09 years) took part in the observational longitudinal two-stage prospective study. At each of the two consecutive stages, at low and high altitudes, arterial Stiffness (SI) and vascular Reflexion (RI) index were measured using a noninvasive photoplethysmographic method, the level of nitric oxide (NO) in saliva by colorimetric method, and hemodynamics of the pulmonary circulation by echocardiography. The statistical analysis of the study findings was carried out using the SPSS Statistics 20 program.

Results. At low altitude, none of the participants showed any disorders of pulmonary hemodynamics, arterial SI and RI, or endogenous NO. During the first 2 days at high altitude, a transient increase of mPAP to more than 20 mmHg was developed (p < 0.05) in 29,7% participants, which was accompanied by a statistically significant increase in the SI (on day 1) and RI (on day 1 and 2) values. The opposite changes were observed in the endogenous NO level, which showed a decrease on the first day at high altitude (p < 0.05).

Conclusion. Some healthy volunteers developed a transient increase in mPAP at high altitude. This is accompanied by a statistically significant increase in SI and RI and a statistically significant decrease in endogenous NO levels, which may indicate the development of endothelial dysfunction.

Rheumatoid arthritis (RA) is a disease that, in addition to affecting joints, is characterized by systemic damage to various localizations, including the lungs. Damage to the respiratory system occurs in about 30 – 40% of cases and may manifest in various ways, necessitating differential diagnosis. One of the manifestations is rheumatoid nodules, which can lead to the formation of cavities in the lungs, hemoptysis, and pneumothorax.

The aim of the work was to demonstrate a clinical case of a long-term follow-up of a patient with lung damage due to rheumatoid arthritis.

Conclusion. The article presents a clinical case of a patient with seropositive RA, who developed lung cavities accompanied by hemoptysis against the background of a prolonged course of the disease. Other causes, such as pulmonary embolism, malignant neoplasms, specific infection, and other systemic diseases, were excluded. Lung damage due to taking a drug from the TNF-alpha inhibitor group (Etanercept) was also considered; however, this option seemed unlikely due to the appearance of new foci after the drug withdrawal. An important step in making a diagnosis in this case was histological examination. The studied material contains signs of pulmonary vasculitis and rheumatoid nodules. Thus, visceral lung damage in RA was verified. This clinical observation demonstrates the need for differential diagnosis of lung cavities in RA with infectious, 

Achieving disease control is a priority in the management of patients with asthma. Recent large studies have demonstrated the positive impact of the use of mobile apps and portable spirometers on achieving asthma control. In addition, data from home spirometry are comparable to those from clinic-based testing with appropriate patient education. The question about the place of modern telemedicine in real clinical practice remains relevant.

The aim of this work was to demonstrate the use of a portable peak flow meter with spirometry and symptom recording functions for remote monitoring of a 67-year-old female patient with newly diagnosed asthma.

Conclusion. The presented clinical case showed that the use of modern telemedicine capabilities can not only help to control the disease, but also improve the patient’s adherence to treatment.

Williams – Campbell syndrome (WCS) is a rare developmental defect characterized by deficiency or complete absence of cartilage mainly in the subsegmental bronchi. Inferiority of the cartilaginous apparatus creates favorable conditions for the development of recurrent lower respiratory tract infection and, as a consequence, the formation of bronchiectasis, which ultimately leads to the appearance and progression of respiratory failure, as well as to a decrease in the quality of life of patients. Insufficient awareness of this disease among doctors leads to later diagnosis, and complex conservative therapy in the absence of specific treatment for WCS entails a positive effect only in the short term.

The aim. Demonstration of a clinical case of a rare respiratory disease – WCS in a 35-year-old man.

Conclusion. This case illustrates the complexities of diagnosing and treating WCS and highlights the importance of raising awareness among healthcare workers regarding this disease.